Prevalence of sexually transmitted infections in female sex workers in Athens, Greece - 2005.

There is little data on the prevalence of STIs in female sex workers, Greek and immigrants, working in Athens, Greece, since most of them work without any form of official license. Our aim was to establish the prevalence of STIs in asymptomatic legal Greek and immigrant female sex workers in Athens, Greece. The study involved an evaluation of gonococcal and chlamydial infection, early infectious syphilis, HIV infection, HSV-2 infection, Hepatitis B and C in 299 female sex workers who applied for an official work permit between May 2005 and October 2005. HSV-2 infection was more common in the Greek sex workers. No difference was found for the other STIs. Prevalence was related to age. A significant association was found between HSV-2 and syphilis. No HIV infection was detected. We concluded that asymptomatic sex workers can be a source of STIs which points out the need for a better health system control in Greece.

Epidemiologic aspects of male gonococcal infection in Greece.

OBJECTIVE: To report male gonorrhea incidence trends between the years 1974 and 1996 and compare the epidemiologic characteristics of the affected population during periods of high and low incidence of the disease. STUDY DESIGN: Retrospective study of all available data for male gonorrhea cases recorded annually in a major STD hospital in Greece since 1974. RESULTS: An abrupt drop in gonorrhea relative incidence occurred in 1986, followed by low rates thereafter. In the context of the overall decline in the incidence of the disease, a shift to older ages, longer time elapsed before seeking medical assistance, and higher proportion of disease repeaters was noticed among the patients. Infections caused by penicillinase-producing gonococci were strongly associated with contacts outside the country or with foreigners and their incidence presented erratic time fluctuations, indicating that they have not been established as endemic in the Greek population. CONCLUSION: The core group hypothesis in terms of nighttime sociosexual activity can be used to interpret most of the findings.

PIP: Trends in Neisseria gonorrhoeae incidence rates in men presenting to a major sexually transmitted disease hospital (Andreas Sygros) in Athens, Greece, in 1974-96 were evaluated and gonorrhea risk factors during periods of low and high incidence were compared. An abrupt drop in the relative incidence of gonorrhea occurred in 1986, followed by low rates thereafter. A comparison of the periods 1974-85 (high incidence) and 1986-96 (low incidence) revealed a 1.27-fold decrease in total attendance to the hospital and a 5-fold decrease in the number of gonorrhea cases detected. Observed over time was a shift to older ages, longer time elapsed before seeking medical assistance, and a higher proportion of disease repeaters. Infections caused by penicillinase-producing gonococci were strongly associated with contacts outside the country or with foreigners and their incidence was characterized by erratic time fluctuations, suggesting that they have not become endemic in the Greek population. Changes observed in the features of the affected population indicate a trend toward increased risk in sexual behavior.

Antimicrobial susceptibility and types of Neisseria gonorrhoeae in Greece. Data for the period 1990 to 1993.

BACKGROUND: Surveillance of the rapidly changing patterns of antimicrobial resistance of Neisseria gonorrhoeae is imperative for monitoring gonococcal infection. GOAL: To describe the types and the antimicrobial susceptibility profile of a representative samples of gonococci isolated in Greece between 1990 and 1993. STUDY DESIGN: The antimicrobial susceptibilities, serovar/auxotypes classes, and plasmid contents of 263 consecutive isolates of N. gonorrhoeae, recovered from cases of male gonococcal urethritis, were determined. RESULTS: Penicillinase-producing N. gonorrhoeae (PPNG) were isolated at a rate of 6.1% and were mostly from imported cases of infection. Six (2.3%) of the isolates (one PPNG and five non-PPNG) were highly resistant to tetracycline, and one PPNG strain was resistant to norfloxacin and ciprofloxacin. Strains with chromosomal resistance to penicillin, tetracycline, erythromycin, and chloramphenicol accounted for 18.5%, 12.5%, 19%, and 16% of the isolates, respectively; much higher proportions of strains were intermediately susceptible to these antibiotics. Spectinomycin and cefotaxime were active against all gonococci studied. A shift to IB serovars and to sporadic types of strains was noted from previous years among the non-PPNG isolates. This is compatible with the marked increase in the rate of imported cases of infection caused by n on-PPNG strains. CONCLUSIONS: The emergence of high-level resistance to tetracycline and resistance to fluoroquinolones was ascertained. At the present, however, the main problem with gonococcal resistance in Greece seems to ensue from the increasing rates of chromosomally resistant strains. Moreover, the increasing frequency of imported gonococci underlines the necessity for continuous epidemiologic surveillance.

Itraconazole in the treatment of tinea corporis and tinea cruris.

Forty-five patients with tinea corporis or tinea cruris were treated with oral itraconazole 100 mg daily for 15 days. At the end of the 15-day treatment, 80% of the patients were healed or had markedly improved. At the first follow-up visit, 2 weeks after stopping therapy, 80% of patients were considered responders. An additional follow-up visit another month later (i.e. 6 weeks post-treatment) showed that 32 of 41 patients had responded (78%). Overall, the mycological cure rate (culture and microscopy negative) was somewhat lower than the clinical response rate. Only three patients reported minor side effects (7%). Nausea was reported by two patients and an urticarial reaction was seen in one patient after 8 days treatment. This latter patient discontinued therapy because of the adverse experience. It is concluded that itraconazole, given at a daily dose of 100 mg for 15 days, is effective in the treatment of tinea corporis and tinea cruris. Response rates at the last visit (6 weeks post-therapy) remained at the same satisfactory levels as at the first follow-up visit (2 weeks post-therapy), even though treatment was stopped after 2 weeks. Itraconazole appears to be well tolerated by patients. These results, both in terms of efficacy and side effects, are in line with results reported by other investigators. The fact that the mycological cure rates were somewhat lower than the clinical response rates had apparently no influence on the relapse rate at 6 weeks follow-up post-therapy.

A double-blind trial of treatment of seborrhoeic dermatitis with 2% ketoconazole cream compared with 1% hydrocortisone cream.

Fifty patients with seborrhoeic dermatitis were treated with 2% ketoconazole cream (n = 24) or with 1% hydrocortisone cream (n = 26) for 4 weeks in a double-blind comparative study. These twice daily applications resulted in 87.2% symptomatic improvement for hydrocortisone vs. 81.6% for ketoconazole. The number of P. ovale yeasts was significantly reduced after the application of ketoconazole compared with hydrocortisone. The incidence of side-effects was low in both groups.